Family Floater Health Insurance: A Comprehensive Guide

Choosing a family floater medical insurance is a smart way of safeguarding your family under a single policy with a shared sum insured. A right plan provides you with financial assistance during emergencies while maintaining an affordable premium compared to other individual plans.

According to the Insurance Regulatory and Development Authority of India (IRDAI), a family floater plan insures family individuals to use a common amount of coverage.

With rapid healthcare and hospitalisation costs in India, the majority of people are opting for floater plans to avail a comprehensive protection. Continue reading to learn more.

What is Family Floater Health Insurance?

Family floater health insurance is a policy that covers your family under one insurance plan. Family floater health insurance policies have a fixed sum insured and offer coverage to your spouse, children, and parents under one product. In case you have extended family, you can also include your in-laws and siblings who are dependent on you.

These plans usually cover expenses related to hospitalisation, pre- and post-hospitalisation expenses, day-care procedures, and ambulance charges. * The family floater policies can be customised based on the requirements of your loved ones by combining add-ons with your policy.

The policy may also cover expenses related to maternity expenses, newborn coverage, and even pre-existing medical conditions, depending on the terms and conditions of the policy. *The premium for a family floater health insurance policy is generally lower than the combined premiums of individual health insurance policies for each family member.

This makes it an affordable option for families who want to ensure that all members are covered under one policy. Therefore, your loved ones are secure for every health-related need in the future!

How Does Family Floater Health Insurance Work?

Let us assume you have bought a family floater health insurance plan with a sum insured of ₹ 5 lakhs.

The total number of family members covered under the policy is five. When a medical need arises, the entire sum insured can be utilised by a single member, or each member can use whatever amount as needed. In the case where a single member finishes the entire sum insured, then no further claims can be made.

Thus, it is advised to choose a coverage amount that secures the medical requirements of all of your loved ones. Family floater mediclaim plans are flexible in nature and are suitable for nuclear families.

With this, you can now opt for a suitable family floater insurance plan and provide your family access to the best medical service. It is recommended to compare health insurance policies and purchase the insurance that satisfies your needs.

What is the Meaning of an Individual Health Insurance Plan?

Each insured individual is covered under an individual health insurance plan separately. Every individual has their own sum insured amount. Any claims filed by a single member do not impact the sum insured of another. This is a distinguishing feature to consider when it comes to comparing family floater vs individual health insurance, particularly for high-risk individuals.

Also Read: Moratorium Period in Health Insurance: Meaning & Benefits

Family Floater vs Individual Health Insurance: Key Differences Explained

The table below highlights the key differences between family floater and individual health insurance plans:

Which plan should you choose?

The answer depends on the size and needs of your family. With Bajaj General Insurance, you can avail the best floater as well as individual health insurance plans, aligning with your needs.

What are the Benefits of a Family Floater Health Insurance Plan?

Choosing the best family floater plan in India involves several benefits. Here are the benefits explained:

Add New Family Members

The most beneficial aspect of having a family floater health insurance policy is the ease of adding new members. In case you have a newborn or want to include another dependent member in the plan, this can be done effortlessly. When compared to buying a separate individual health plan for the person, you can save money with this kind of policy. **

Family Floater Insurance Premium is Cost-Effective

As a family floater plan covers the entire family under one policy, the premium is much more affordable. If you had to buy separate individual policies for each member, the premium cost could burn a hole through your wallet.

Medical inflation in India is recorded at 11-13%, enabling health insurance to be essential for families. Choosing the right family floater health insurance secures your medical expenses.

Cashless Hospitalisation

Insurance providers have a set number of network hospitals where you can seek treatment, and they settle the bills directly. This is termed cashless hospitalisation, where the medical bill is directly settled with the insurer. Thus, you can get the required treatment at almost zero cost and do away with the tedious reimbursement procedure.

Tax Benefits

You can enjoy tax benefits after purchasing a family floater policy under Section 80D of the Income Tax Act of 1961. The premiums paid for the policy can be claimed for income tax deductions. But it is advised to avoid opting for a health insurance plan only for tax-saving and get the most from your policy. 

Also Read: How Group Health Insurance Works When Changing Jobs?

Family Floater Health Insurance: What It Does Not Cover

Here are the key exclusions of a family floater medical insurance:

Pre-existing Conditions

Most family floater health insurance policies do not cover pre-existing medical conditions. This means that if any member of the family has a condition that has been diagnosed before the purchase of the policy, expenses related to that condition may not be covered under the policy.

Cosmetic Procedures

A family floater plan usually does not cover expenses related to cosmetic procedures, such as plastic surgery or hair transplants, unless they are medically necessary.

Non-medical Expenses

Expenses that are not directly related to medical treatment, such as administrative charges, service charges, or admission fees, may not be covered under the policy.

Self-inflicted Injuries

Family floater health insurance policies do not cover expenses related to self-inflicted injuries or injuries sustained due to participation in hazardous activities or sports.

Health Issues Due to War or Nuclear Activity

Any health hazards or disorders that occur due to nuclear or radioactive activity in your geographical area are not covered under family floater health insurance plans.

Alcohol or Drug-Induced Health Disorders

Medical expenses that may arise as a result of abuse of alcohol, drugs, or other intoxicating substances are usually excluded under family health insurance plans. It's important to thoroughly read and understand the terms and conditions of your family floater insurance policy to be aware of the exclusions. This can help you plan for medical expenses that may not be covered under the policy and make informed decisions about your family's health coverage.

Also Read: Individual Health Insurance vs Family Floater Plan

How is Premium Calculated for a Family Floater Health Insurance Plan?

The majority of insurance companies nowadays calculate the family floater health insurance premium considering the age of the oldest insured member, medical history, sum insured, city of residence, and number of family members covered under the plan. Usually, an older member needs to pay high premiums.

Follow the table below for a detailed understanding:

What are the Tax Benefits Under Family Floater Health Insurance Plan?

A family floater medical insurance plan not only offers comprehensive health coverage for your family but can also provide tax benefits. Here are some tax benefits associated with a family floater health insurance policy:

Tax Deduction Under Section 80D

Premiums paid towards a family floater health insurance policy are eligible for tax deduction under Section 80D of the Income Tax Act, 1961. The maximum deduction available is Rs. ₹25,000 for premiums paid towards health insurance for self, spouse, and dependent children. If parents are also covered under the policy, an additional deduction of up to Rs. ₹25,000 can be claimed. If either the insured or the parent is a senior citizen, the deduction limit increases to Rs. ₹50,000.

Additional Deduction for Preventive Health Check-ups

Under Section 80D, an additional deduction of up to Rs. ₹5,000 can be claimed for expenses incurred towards preventive health check-ups for self, spouse, and dependent children.

No Tax on Policy Payout

In case of hospitalisation or medical treatment, if the policy payout is received, it is not taxable under the Income Tax Act.

Tax Benefit for Employer-Provided Health Insurance

If your employer provides you with a family floater health insurance policy, the premium paid by the employer is not considered taxable income for the employee.

However, it is always advisable to choose private health insurance plans for yourself and your family. It is strongly recommended to talk with a tax professional to understand the detailed implications of taxes under a family floater health insurance plan. Also, understand how to maximise the tax benefits associated with health insurance.

The main question that arises: Is your family actually prepared to handle medical emergencies if there is no health insurance policy?

If not, do not wait any longer.

Choose the most affordable health plans, namely, the Family Health Care (Silver) offered by Bajaj General Insurance, and ensure peace of mind for your loved ones during emergencies.

Also Read: Health Insurance Portability: How to Transfer Online?

Conclusion

In summary, a family floater mediclaim policy is a convenient and practical solution for families to protect themselves against unforeseen medical expenses. Covering the medical costs of all family members under a single policy eliminates the need to purchase multiple individual policies, saving both time and money.

Additionally, family floater policies often provide coverage for a broader range of medical procedures. However, it is essential to carefully consider the family Mediclaim policy's features, including the coverage limits, exclusions, waiting periods, and deductibles, before purchasing a family floater health insurance policy. It is also crucial to choose a policy that offers an extensive network of hospitals and healthcare providers, ensuring access to quality healthcare services when needed.

Frequently Asked Questions

How is the premium for a family floater health insurance calculated?

The premium of a family floater health insurance policy depends on several factors, including the age of the eldest member, the number of members covered, the sum insured, add-ons, lifestyle, and overall medical history.

Which family members can be included in a family floater health insurance plan?

A family floater health insurance policy can cover you, your spouse, your dependent children, and your parents. Some plans also allow dependent siblings or in-laws, ensuring Senior Citizens Health Insurance coverage under one policy.

Do family floater plans offer cashless hospitalisation?

Yes, family floater health insurance plans do offer cashless hospitalisation, and with Bajaj General Insurance, you can avail this benefit at over 18400 network hospitals across India. This means your medical bills are settled directly with the hospital, so you or your family members do not need to pay upfront during treatment.

Who is eligible to be covered under a family floater plan?

Most family floater health insurance policies cover adults aged 18–65, including Senior Citizens Health Insurance, along with dependent children. Bajaj General Insurance tailors coverage to suit nuclear and joint families for complete protection.

Can I convert an individual health insurance policy to a family floater plan?

Yes, Bajaj General Insurance allows policyholders to shift from individual health cover to a family floater health insurance policy, offering cost savings and consolidated benefits under one comprehensive plan for the entire family.

Can I add or remove members during the policy tenure?

Yes, you can add a newborn or dependent and remove members as needed. Bajaj General Insurance makes modifications simple, ensuring your family floater health insurance policy evolves with your family’s changing needs.

*Standard T&C apply

**Insurance is the subject matter of solicitation. For more details on benefits, exclusions, limitations, terms, and conditions, please read the sales brochure/policy wording carefully before concluding a sale.

***Disclaimer: The content on this page is generic and shared only for informational and explanatory purposes. It is based on several secondary sources on the internet and is subject to changes. Please consult an expert before making any related decisions.